Insurance Department

Contract with Alicare Inc.

The New York State Health Care Reform Act of 2000 established certain health insurance programs for individuals who are unable to obtain group health insurance, such as unemployed individuals, sole proprietors, and individuals whose employers do not provide group health insurance. The health insurers participating in these programs may be reimbursed by the State for high-cost claims. These reimbursements are made from special funds that are overseen by the Insurance Department and administered by the contractor. We audited selected reimbursements to determine whether they were made for eligible recipients, and found that they were. We also audited the contractor’s performance under the contract and found that it met all contract requirements.